{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:32:48Z","timestamp":1787761968052,"version":"build-2784847793"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,6]]},"abstract":"\n Background and Aims:<\/jats:title>\n \n Epidural blood patch (EBP) is performed by injecting autologous blood into the epidural space using a Tuohy needle. Certain clinical scenarios mandate an epidural catheter (EC)-assisted EBP. Collecting blood in a 20-ml versus 5-ml syringe appears to influence the quality of the clot. This\n in vitro<\/jats:italic>\n study compared the techniques of performing the EC-assisted EBP using 20-ml versus 5-ml syringe on clotting time (CT), clot retraction (CR) and haemolysis.\n <\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n This\n in vitro<\/jats:italic>\n study was performed in a haematology laboratory. Five consented adult healthy male volunteers donated blood. In the 5-ml syringe technique, blood was injected through an EC, and as it flowed out of the tip, it was collected at the beginning and the end of 1 min. With the 20-ml technique, blood was collected at the beginning and end of the first, second and third minute. The samples were tested for CT, CR and haemolysis by measuring the plasma-free haemoglobin (PFHb).\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Five injections were made using a 5-ml syringe, and another five with a 20-ml syringe. Injection time was shorter in the 5-ml technique (80.80 \u00b1 5.89 vs. 272 \u00b1 28.4 s,\n P<\/jats:italic>\n < 0.0001). With the 20-ml technique, CT progressively increased (>15 min), whereas, with the 5-ml syringe, the CT was normal. Both techniques caused mild, insignificant haemolysis (PFHb >0.005 g\/dl), without affecting the quality of CR.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n EC-assisted EBP using a 5-ml syringe technique shortens the injection time and deposits fresh blood quickly without affecting CT and CR.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ija.ija_849_22","type":"journal-article","created":{"date-parts":[[2023,6,14]],"date-time":"2023-06-14T01:00:09Z","timestamp":1686704409000},"page":"544-547","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Comparing two techniques of performing an epidural catheter-assisted epidural blood patch using a 20 ml syringe versus a 5 ml syringe and its effect on clotting time, the strength of clot retraction and haemolysis \u2013 A prospective in vitro study (EC-EBP study)"],"prefix":"10.4103","volume":"67","author":[{"given":"Ramamani","family":"Mariappan","sequence":"first","affiliation":[{"name":"Department of Neuroanaesthesia, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Snehil","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine and Immunohaematology, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishnaprabhu","family":"Raju","sequence":"additional","affiliation":[{"name":"Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dolly","family":"Daniel","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine and Immunohaematology, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sukesh Chandran","family":"Nair","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine and Immunohaematology, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sathya","family":"Subramani","sequence":"additional","affiliation":[{"name":"Department of Physiology, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,6,14]]},"reference":[{"key":"R1-20240902","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1111\/j.1468-2982.2008.01776.x","article-title":"Spontaneous spinal cerebrospinal fluid leaks","volume":"28","author":"Schievink","year":"2008","journal-title":"Cephalalgia Int J Headache"},{"key":"R2-20240902","first-page":"816","article-title":"Delayed symptoms of a cerebrospinal fluid leak following lumbar decompression","volume":"31","author":"Brookfield","year":"2008","journal-title":"Orthopedics"},{"key":"R3-20240902","doi-asserted-by":"crossref","first-page":"2173","DOI":"10.1056\/NEJMra2101561","article-title":"Spontaneous intracranial hypotension","volume":"385","author":"Schievink","year":"2021","journal-title":"N Engl J Med"},{"key":"R4-20240902","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.jocn.2015.07.009","article-title":"Spontaneous intracranial hypotension:Targeted or blind blood patch","volume":"25","author":"Smith","year":"2016","journal-title":"J Clin Neurosci"},{"issue":"(eLetters supplement)","key":"R5-20240902","article-title":"Is the epidural blood patch performed through an epidural catheter instead of an epidural needle?Br J Anaesth","volume":"109","author":"Muslu","year":"2012"},{"key":"R6-20240902","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.wneu.2019.11.169","article-title":"Total spinal epidural \u201cblood patch\u201dapplication through a racz catheter in spontaneous intracranial hypotension","volume":"135","author":"Hatano","year":"2020","journal-title":"World Neurosurg"},{"key":"R7-20240902","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1213\/XAA.0000000000001086","article-title":"A safe method for performing an epidural blood patch in a pediatric patient requiring deep sedation for epidural catheter placement:A case report","volume":"13","author":"Heine","year":"2019","journal-title":"A A Pract"},{"key":"R8-20240902","doi-asserted-by":"crossref","first-page":"394","DOI":"10.4103\/sja.SJA_779_19","article-title":"Management of postdural puncture headache in pediatric using an epidural catheter for an epidural blood patch","volume":"14","author":"Wosaibai","year":"2020","journal-title":"Saudi J Anaesth"},{"key":"R9-20240902","doi-asserted-by":"crossref","first-page":"1476","DOI":"10.1213\/ANE.0b013e31822e5665","article-title":"High thoracic\/cervical epidural blood patch for spontaneous cerebrospinal fluid leak:A new challenge for anesthesiologists","volume":"113","author":"Nipatcharoen","year":"2011","journal-title":"Anesth Analg"},{"key":"R10-20240902","first-page":"Paper 770","article-title":"1980-, \u201cHemolysis in needles.\u201dElectronic Theses and Dissertations","author":"Kommidi Giridhar","year":"2008"}],"container-title":["Indian Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.ija_849_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:12:26Z","timestamp":1787760746000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.ija_849_22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6]]},"references-count":10,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/ija.ija_849_22","relation":{},"ISSN":["0019-5049","0976-2817"],"issn-type":[{"value":"0019-5049","type":"print"},{"value":"0976-2817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6]]},"assertion":[{"value":"2022-10-13","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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